Archives of Head and Neck Surgery
Archives of Head and Neck Surgery
Original Article Larynx, hypopharynx and tracheal diseases and tumors

Comparative analysis of quality of life in advanced laryngeal and oral cancer undergoing extensive surgeries

Fernanda Gonzalez Rocha Souza, Izabella Costa Santos, Andressa Silva de Freitas, Luiz Claudio Santos Thuler, Anke Bergmann, Emilson Queiroz Freitas, Fernando Luiz Dias

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Introduction: Total laryngectomy has significant impact in vital functions of patients as breath, swallow and speech, and may influence their quality of life. The COMMANDO surgery followed by adjuvant radiotherapy is a mutilating surgery that impacts patients swallowing, saliva, chewing, and speech, interfering with their quality of life. Objective: To describe and evaluate comparatively factors associated with lower quality of life in patients with advanced larynx and oral cavity cancer undergoing extensive surgeries. Materials and Methods: 95 patients with laryngeal cancer and 47 with oral cavity cancer underwent extensive surgeries. The fourth version of University of Washington Quality of Life Questionnaire (UW-QOL) was used. Results: Regarding the subjective domains, they evaluate quality of life related to health as good in both subsites. Worst scores in QOL domains after total laryngectomy were presented in mood, activity, rehabilitation through esophageal speech and absence of vocal emission. Worst scores in QOL domains after COMMANDO were presented in chewing, swallowing, speech, and absence of saliva. The average composite score for quality of life in larynx was 80.4 and oral cavity was 64.6. Conclusion: The high value for the average composite score of QOL after total laryngectomy showed positive assessment of QOL compared to lower values reported after COMMANDO. The absence of vocal emission was the only domain independently associated with a decreased QOL according to the UW-QOL. Oral cavity patients reported that they cannot even chew soft foods and can only eat some solid food.


quality of life; head and neck cancer; surgery.


1. International Agency for Research on Cancer. GLOBOCAN. Section of cancer surveillance [Internet]. France: IARC; 2012 [cited 2014 Oct 9]. Available from:

2. Instituto Nacional de Câncer José Alencar Gomes da Silva. Coordenação de Prevenção e Vigilância. Estimativa 2018: incidência do câncer no Brasil. Rio de Janeiro: INCA; 2017. 128 p.

3. Oozeer NB, Owen S, Perez BZ, Jones G, Welch AR, Paleri V. Functional status after total laryngectomy: cross-sectional survey of 79 laryngectomees using the Performance Status Scale for Head and Neck Cancer. J Laryngol Otol. 2010;124(4):412-6. PMid:20003587.

4. Williamson JS, Ingrams D, Jones H. Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study. Ann R Coll Surg Engl. 2011;93(8):591-5. PMid:22041234.

5. Magrin J, Sanabria A, Kowalski LP. Tratamento do câncer avançado de boca. In: Parise O, Kowalski LP, Lehn C, editors. Câncer de cabeça e pescoço: diagnóstico e tratamento. 1. ed. rev. São Paulo: Âmbito Editores; 2008.

6. World Health Organization. Measuring quality of life. Genève: WHO/MSA/MNH/PSF; 1997.

7. Rogers SN, Lowe D. Screening for dysfunction to promote multidisciplinary intervention by using the University of Washington Quality of Life Questionnaire. Arch Otolaryngol Head Neck Surg. 2009;135(4):369-75. PMid:19380359.

8. Hassan SJ, Weymuller EA Jr. Assessment of quality of life in head and neck cancer patients. Head Neck. 1993;15(6):485-96. PMid:8253555.

9. Laraway DC, Rogers SN. A structured review of journal articles reporting outcomes using the University of Washington Quality of Life Scale. Br J Oral Maxillofac Surg. 2012;50(2):122-31. PMid:21239091.

10. Souza FGR, Santos IC, Bergmann A, Thuler LCS, Dias FL. Assessment of quality of life in patients with advanced laryngeal malignancies undergoing radical surgery. In: Abstracts of the AHNS Annual Meeting; 2016; Washington. Chicago: American Medical Association; 2016.

11. Metcalfe CW, Lowe D, Rogers SN. What patients consider important: temporal variations by early and late stage oral, oropharyngeal and laryngeal subsites. J Craniomaxillofac Surg. 2014;42(5):641-7. PMid:24238983.

12. Vartanian JG, Carvalho AL, Yueh B, Furia CL, Toyota J, McDowell JA, Weymuller EA Jr, Kowalski LP. Brazilian-Portuguese validation of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer. Head Neck. 2006;28(12):1115-21. PMid:16823873.

13. Sobin L, Wittekind C. TNM classification of malignant tumours. 6th ed. New York:j Wiley-Liss; 2002. p. 99-103.

14. Weymuller EA Jr, Yueh B, Deleyiannis FWB, Kuntz AL, Alsarraf R, Coltrera MD. Quality of life in patients with head and neck cancer: lessons learned from 549 prospectively evaluated patients. Arch Otolaryngol Head Neck Surg. 2000;126(3):329-35. PMid:10722005.

15. El-Deiry MW, Futran ND, McDowell JA, Weymuller EA Jr, Yueh B. Influences and Predictors of Long-term Quality of Life in Head and Neck Cancer Survivors. Arch Otolaryngol Head Neck Surg. 2009;135(4):380-4. PMid:19380361.

16. Rogers SN, Lowe D, Yueh B, Weymuller EA Jr. The Physical Function and SocialEmotional Function Subscales of the University of Washington Quality of Life Questionnaire. Arch Otolaryngol Head Neck Surg. 2010;136(4):352-7. PMid:20403851.

17. Silveira AP, Gonçalves JJ, Sequeira T, Ribeiro C, Lopes C, Monteiro E, Pimentel FL. Geriatric oncology: comparing health related quality of life in head and neck cancer patients. Head Neck Oncol. 2011;3(1):3. PMid:21232097.

18. Eadie TL, Bowker BC. Coping and quality of life after total laryngectomy. Otolaryngol Head Neck Surg. 2012;146(6):959-65. http://dx.doi. org/10.1177/0194599812437315. PMid:22307574.

19. Ghazali N, Lowe D, Rogers SN. Enhanced patient reported outcome measurement suitable for head and neck cancer follow-up clinics. Head Neck Oncol. 2012;4(1):32. PMid:22695251.

20. Balm AJ, Van den Brekel MWM, Tan IB, Hilgers FJM. The indwelling voice prosthesis for speech rehabilitation after total laryngectomy: a safe approach. Otolaryngol Pol. 2011;65(6):402-9. PMid:22208935.

21. Van der Molen L, Kornman AF, Latenstein MN, Van den Brekel MW, Hilgers FJ. Practice of laryngectomy rehabilitation interventions: a perspective from Europe/the Netherlands. Curr Opin Otolaryngol Head Neck Surg. 2013;21(3):230-8. PMid:23572017.

22. Thomas L, Moore EJ, Olsen KD, Kasperbauer JL. Long-term quality of life in young adults treated for oral cavity squamous cell cancer. Ann Otol Rhinol Laryngol. 2012;121(6):395-401. PMid:22737962.

23. Yang W, Zhao S, Liu F, Sun M. Health-related quality of life after mandibular resection for oral cancer: Reconstruction with free fibula flap. Med Oral Patol Oral Cir Bucal. 2014;19(4):e414-8. PMid:24608209.

24. López-Jornet P, Camacho-Alonso F, López-Tortosa J, Palazon Tovar T, RodríguezGonzales MA. Assessing quality of life in patients with head and neck cancer in Spain by means of EORTC QLQ-C30 and QLQ-H&N35. J Craniomaxillofac Surg. 2012;40(7):614-20. PMid:22425499.

25. Gill SS, Frew J, Fry A, Adam J, Paleri V, Dobrowsky W, Chatterjee S, Kelly CG. Priorities for the head and neck cancer patient, their companion and members of the multidisciplinary team and decision regret. Clin Oncol. 2011;23(8):518-24. PMid:21550217.

26. Gonçalves JJ, Rocha AM. A decision support system for quality of life in head and neck oncology patients. Head Neck Oncol. 2012;4(1):3. PMid:22340746.

27. Silveira AP, Gonçalves JJ, Sequeira T, Ribeiro C, Lopes C, Monteiro E, Pimentel FL. Patient reported outcomes in head and neck cancer: selecting instruments for quality of life integration in clinical protocols. Head Neck Oncol. 2010;2(1):32. PMid:21040524.

28. Lang H, France E, Williams B, Humphris G, Wells M. The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psychooncology. 2013;22(12):2648-63. PMid:23840037.

29. Kanatas A, Ghazali N, Lowe D, Rogers SN. The identification of mood and anxiety concerns using the patients concerns inventory following head and neck cancer. Int J Oral Maxillofac Surg. 2012;41(4):429-36. PMid:22264641.

30. Ghazali N, Cadwallader E, Lowe D, Humphris G, Ozakinci G, Rogers SN. Fear of reccurrence among head and neck cancer survivors: longitudinal trends. Psychooncology. 2013;22(4):807-13. PMid:22451036.

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